Recognition of and intent to use gastrostomy or ventilator treatments in older patients with advanced dementia: Differences between laypeople and healthcare professionals in Japan

Autor: Kouji Nomura, Takamasa Watanabe, Akinari Moriya, Takuya Nagata, Yasuhiko Miura, Yoko Hirayama, Tomokazu Tominaga, Masato Matsushima, Ayako Kawasaki
Rok vydání: 2014
Předmět:
Zdroj: Geriatrics & Gerontology International. 15:318-325
ISSN: 1444-1586
DOI: 10.1111/ggi.12276
Popis: Aim We compared differences between laypeople and healthcare professionals in the recognition of and intent to use gastrostomy and ventilator treatments in older patients with dementia. Methods Between November 2011 and January 2012, a questionnaire survey was carried out. People who underwent a general health check-up at Nomura Hospital Preventive Medical Center were recruited as the laypeople group. Physicians and nurses working in Mitaka, Tokyo, Japan, were recruited as the healthcare professional group. We assessed the recognition rate of ventilator and gastrostomy treatments. Then we provided two scenarios for participants to determine whether these methods represented life-sustaining treatments that will simply delay an inevitable death. Intentions were compared between cases with and without advance directives. Results Approximately 60% of laypeople did not know what gastrostomy is. Healthcare professionals were more likely to recognize a ventilator as a life-sustaining treatment; in contrast, there were no significant differences in judgments regarding gastrostomy. Both groups were more likely to have intent to use a gastrostomy and a ventilator for family members than themselves. Furthermore, healthcare professionals were more likely to want to use these items for patients than their family members. Advance directive for withholding life-sustaining treatment reduced the intention to use these treatments. Conclusion It is necessary to increase our understanding regarding knowledge of end-of-life care options of both laypeople and healthcare professionals. Geriatr Gerontol Int 2015; 15: 318–325.
Databáze: OpenAIRE